Susceptibility to Varicella-Zoster Virus Among Adults at High Risk for Exposure

1986 ◽  
Vol 7 (9) ◽  
pp. 448-451 ◽  
Author(s):  
Sherman J. Alter ◽  
Jeanne A. Hammond ◽  
Carol J. McVey ◽  
Martin G. Myers
Keyword(s):  
Health Care ◽  
Varicella Zoster Virus ◽  
Health Care Providers ◽  
Total Population ◽  
Prior Experience ◽  
Adult Health ◽  
Care Providers ◽  
Varicella Zoster ◽  
Hospital Employees ◽  
Adult Health Care

AbstractThe adult health care provider who is susceptible to varicella zoster virus (VZV) represents a risk to her or himself and to patients. Nineteen percent of employees at this Children's Hospital had no or uncertain prior experience with VZV, and of these, 28% were found to be VZV susceptible, representing 5% of the total population of 2,730 hospital employees. During the 12 months of study, six of the potential 135 to 137 VZV-susceptible individuals acquired varicella. VZV-susceptible health care providers should be aware of their potential to both acquire and transmit VZV.

scholarly journals Lost in Transition: Health Care Experiences of Adults Born Very Preterm—A Qualitative Approach

2020 ◽  
Vol 8 ◽  
Author(s):  
Anna Perez ◽  
Luise Thiede ◽  
Daniel Lüdecke ◽  
Chinedu Ulrich Ebenebe ◽  
Olaf von dem Knesebeck ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Adult Health ◽  
Care Providers ◽  
Very Preterm ◽  
Care Services ◽  
Health Care Satisfaction ◽  
Care Satisfaction ◽  
Adult Health Care

Introduction: Adults Born Very Preterm (ABP) are an underperceived but steadily increasing patient population. It has been shown that they face multiple physical, mental and emotional health problems as they age. Very little is known about their specific health care needs beyond childhood and adolescence. This article focuses on their personal perspectives: it explores how they feel embedded in established health care structures and points to health care-related barriers they face.Methods: We conducted 20 individual in-depth interviews with adults born preterm aged 20–54 years with a gestational age (GA) below 33 weeks at birth and birth weights ranging from 870–1,950 g. Qualitative content analysis of the narrative interview data was conducted to identify themes related to self-perceived health, health care satisfaction, and social well-being.Results: The majority (85%) of the study participants reported that their former prematurity is still of concern in their everyday lives as adults. The prevalence of self-reported physical (65%) and mental (45%) long-term sequelae of prematurity was high. Most participants expressed dissatisfaction with health care services regarding their former prematurity. Lack of consideration for their prematurity status by adult health care providers and the invisibility of the often subtle impairments they face were named as main barriers to receiving adequate health care. Age and burden of disease were important factors influencing participants' perception of their own health and their health care satisfaction. All participants expressed great interest in the provision of specialized, custom-tailored health-care services, taking the individual history of prematurity into account.Discussion: Adults born preterm are a patient population underperceived by the health care system. Longterm effects of very preterm birth, affecting various domains of life, may become a substantial burden of disease in a subgroup of formerly preterm individuals and should therefore be taken into consideration by adult health care providers.

scholarly journals P1820THE DEVELOPMENT OF TRANSITION SERVICES IN RENAL CARE IN SYNERGY WITH YOUNG PATIENTS, PARENTS AND PEDIATRIC AND ADULT HEALTH CARE PROVIDERS: A CO-CREATION APPROACH

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Holvoet Els ◽  
Wim Van Biesen ◽  
Liesbeth Van Humbeeck
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Transition To Adulthood ◽  
Health Care Providers ◽  
Transition Process ◽  
Adult Health ◽  
Care Providers ◽  
Adult Care ◽  
Current State ◽  
Adult Health Care

Abstract Background and Aims Healthcare transition to adulthood is recognised as challenging for adolescents and young adults (AYA’s) diagnosed with chronic kidney disease. Therefore the implementation of a transition programme adjusted to the needs of this patient population is of great importance. However, rarely are the views of young people or their families sought about the process or relevant outcome of their transition process. The aim of this study was to co-develop a transition programme that (1) enables health care providers to facilitate improving transition outcomes from the perspective of all stakeholders, and (2) enhances self-management by young people with chronic kidney disease. Method The development of this programme involved (1) an extensive review of currently existing best-practices (published and unpublished), and (2) understanding the current state of transition practice at our centre by means of semi-structured interviews and focus groups with patients, parents and health care providers of both pediatric and adult side. Results A working group was established incorporating a reflective process designed to develop a community of practice. During the process, participants’ experiences, lessons learned from the review of current state of evidence and practice, and appreciation of the (changing) context within which participants were working were incorporated. Analysis revealed 6 core elements as the foundation of the transition program: the AYA as the main focus, involvement of the parents, holistic approach, flexibility, forward-looking approach, continuity in guidance and follow-up. We also identified the need to distinguish the difference between transitioning from child to teenager to young adult and the actual transfer between paediatric and adult care. The actual final proposed transition programme can be divided in 4 phases: (1) introduction of the transition process to parents and patients, (2) guiding the patient to become more independent and to gain insight in the disease and related themes, (3) managing the transfer to adult health care and (4) finalizing the transition care plan. Adequate on-going communication and collaboration between paediatric and adult care seems essential for achieving a successful program. Conclusion This study addressed the development of a transition programme as a multi-actor process wherein patients, parents and health care providers significantly contribute to the transition to adulthood and transfer to adult care.

Single Rescuer Ventilation Using a Bag Valve Mask with Removable External Handle: A Randomized Crossover Trial

2017 ◽  
Vol 32 (6) ◽  
pp. 625-630 ◽  
Author(s):  
Paul Reed ◽  
Baruch Zobrist ◽  
Monica Casmaer ◽  
Steven G. Schauer ◽  
Nurani Kester ◽  
...  
Keyword(s):  
Health Care ◽  
Tidal Volume ◽  
Health Care Providers ◽  
Crossover Trial ◽  
Rest Period ◽  
Primary Outcome Measure ◽  
Adult Health ◽  
Care Providers ◽  
Publication Type ◽  
Randomized Crossover Trial

AbstractIntroductionVentilation with a bag valve mask (BVM) is a challenging but critical skill for airway management in the prehospital setting.HypothesisTidal volumes received during single rescuer ventilation with a modified BVM with supplemental external handle will be higher than those delivered using a standard BVM among health care volunteers in a manikin model.MethodsThis study was a randomized crossover trial of adult health care providers performing ventilation on a manikin. Investigators randomized participants to perform single rescuer ventilation, first using either a BVM modified by addition of a supplemental external handle or a standard unmodified BVM (Spur II BVM device; Ambu; Ballerup, Denmark). Participants performed mask placement and delivery of 10 breaths per minute for three minutes, as guided by a metronome. After a three-minute rest period, they performed ventilation using the alternative device. The primary outcome measure was mean received tidal volume as measured by the manikin (IngMar RespiTrainer model; IngMar Medical; Pittsburgh, Pennsylvania USA). Secondary outcomes included subject device preference.ResultsOf 70 recruited participants, all completed the study. The difference in mean received tidal volume between ventilations performed using the modified BVM with external handle versus standard BVM was 20 ml (95% CI, -16 to 56 ml; P=.28). There were no significant differences in mean received tidal volume based on the order of study arm allocation. The proportion of participants preferring the modified BVM over the standard BVM was 47.1% (95% CI, 35.7 to 58.6%).ConclusionsThe modified BVM with added external handle did not result in greater mean received tidal volume compared to standard BVM during single rescuer ventilation in a manikin model.ReedP, ZobristB, CasmaerM, SchauerSG, KesterN, AprilMD. Single rescuer ventilation using a bag valve mask with removable external handle: a randomized crossover trial. Prehosp Disaster Med. 2017;32(6):625–630.

Education on Advanced Disaster Medical Response: Initial Experience in Brazil

2016 ◽  
Vol 5 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Romeo L Simões ◽  
Alcir E Dorigatti ◽  
Bruno M Pereira ◽  
Susan M Briggs
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Massachusetts General Hospital ◽  
Prior Experience ◽  
Disaster Medicine ◽  
Initial Experience ◽  
Care Providers ◽  
Medical Response ◽  
Trauma Society ◽  
The Impact

ABSTRACT Background One of the most important mainstays in disaster management is preparedness. In partnership with the International Trauma & Disaster Institute, Massachusetts General Hospital, Boston, and the Panamerican Trauma Society (PTS), the Brazilian Society of Integrated Assistance to the Traumatized (SBAIT) has been promoting, for the last 4 years, education and training through the “Advanced Disaster Medical Response” (ADMR) course for health care providers. The aim of this study is to evaluate the impact of the ADMR course on medical staff learning. Materials and methods Between 2011 and 2014, 23 ADMR courses (each of 8 hours duration) were conducted in Brazil. Attendees answered a pretest and posttest survey to evaluate their experience in disaster medicine and acquired knowledge during the course. Each test consisted of the same 10 objective questions, resulting in a score of 0 to 10. Attendees had to do both tests in order to qualify for a course certificate. Results In 4 years, 1,398 students participated in the courses. Participants were predominantly physicians and medical students of the male gender. Posttest scores were significantly higher than those of the pretests: 9 (±1.22) and 7 (±1.67) respectively, representing an increase of 34.1% in acquired knowledge. Students with prior experience in disaster medical response (p<0.05) or participation in multiple-casualty simulations (p<0.05) or theoretical training (p<0.05) scored better on pretests than those without similar experience. For every kind of prior experience, posttest scores were higher than pretests (p<0.05). Conclusion The ADMR course is an effective learning tool for medical personnel and health care providers, increasing knowledge of disaster medical response. How to cite this article Simões RL, Dorigatti AE, Pereira BM, Calderan TRA, Briggs SM, Fraga GP. Education on Advanced Disaster Medical Response: Initial Experience in Brazil. Panam J Trauma Crit Care Emerg Surg 2016;5(2):76-82.

Emotional aspects of transiting HIV-infected adolescents to an adult health care in the southeast Brazil: A new challenge

2011 ◽  
Vol 26 (S2) ◽  
pp. 891-891
Author(s):  
D.M. Machado ◽  
R.C.M. Succi ◽  
E. Galano ◽  
E.R. Turato
Keyword(s):  
Health Care ◽  
Qualitative Content Analysis ◽  
Qualitative Approach ◽  
Hiv Care ◽  
Adult Health ◽  
Care Providers ◽  
Health Care Teams ◽  
Risk Of Rupture ◽  
Emotional Aspects ◽  
Adult Health Care

IntroductionAdolescents who was born with HIV, usually followed by paediatricians, present new challenges to health care teams during transition to adult medical care.ObjectiveTo discuss the emotional meanings of transitioning this group to adult health care.MethodClinical-qualitative approach with preliminary interviews conducted with eight HIV-infected adolescents followed at Federal University of São Paulo, Brazil. The data were processed through Qualitative Content Analysis and discussed based on theoretical psychodynamic frameworks.ResultsThe emergent themes were feelings of loss, risk of rupture of solid ties and unpreparedness to changes perceived as threatening. The transition to adult health care points to the need for developing patient self-care: “... I have to take more responsibility, I’m not ready, I’m still a teenager.” They also mentioned concerns in moving away from their paediatricians, “here is like a family. I feel like they care about me ... they are not just doctors... kind of teacher... mother, you know, “If I have to leave, I’ll cry... “Is there a place where the paediatricians could follow us until 30 years?” On the other hand, there were testimonies showing compliance or interest in changing, it's normal, I’m older, I have to stay right there”, “I’m the oldest ... it's weird to be among children.”ConclusionsAlthough adolescents understand the need of transition of health care, they manifest several difficulties. Individualized transitioning plans and increasing interaction between paediatric and adult HIV care providers could better address the needs of this unique population.

scholarly journals Using Telemedicine During the COVID-19 Pandemic: Attitudes of Adult Health Care Consumers in Israel

2021 ◽  
Vol 9 ◽  
Author(s):  
Sima Reicher ◽  
Tal Sela ◽  
Orly Toren
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Chronic Conditions ◽  
Medical Attention ◽  
Adult Health ◽  
Care Providers ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
The Future ◽  
Willingness To Use

Introduction: The COVID-19 pandemic has affected health care services worldwide due to lockdowns, prevention measures, and social distancing. During this period, patients, including older adults and those with chronic conditions, need ways to obtain medical attention other than going physically to the clinic, such as telemedicine services. The purpose of the present study was to evaluate attitudes toward telemedicine during the COVID-19 lockdown in Israel, assess willingness to use such services in the future, and evaluate the extent to which consumers have changed their minds regarding these services.Method: A cross-sectional, descriptive, correlational study was conducted among adults (age 20–90) using social media networks (N = 693). Data were collected using an online questionnaire explicitly designed to measure attitudes toward telemedicine.Results: Most of the participants had to use telemedicine during the lockdown and were satisfied therewith. The majority also stated that they would continue using telemedicine in the future. However, only a third stated that they had changed their minds regarding telemedicine. The main predictors of willingness to use telemedicine in the future were the necessity of using such services during lockdown, preference for going to a clinic, and satisfaction with telemedicine, alongside gender and having a chronic illness. Importantly, we found that a preference for visiting the clinic was negatively correlated with willingness to use telemedicine in the future. Education and being single were predictors of the change of mind regarding telemedicine. Participants with chronic conditions are more likely to use these services, and specific attention should be directed to their needs. A small portion of the study sample prefers live appointments with a physician.Conclusions: Telemedicine use is rapidly changing. It is vital for health care providers to identify non-telemedicine users and their common characteristics. Monitoring patients' attitudes regarding telemedicine is essential in the future after the pandemic ends. Targeted outreach plans should be formulated. These plans should be directed at identifying barriers to using telemedicine, and they should generate specific, focused plans.

scholarly journals Profile of the first cases hospitalized due to Influenza A (H1N1) in Panama City, Panama. May-June 2009.

2009 ◽  
Vol 3 (11) ◽  
pp. 811-816 ◽  
Author(s):  
Felicia Tulloch ◽  
Ricardo Correa ◽  
Gladys Guerrero ◽  
Rigoberto Samaniego ◽  
Mariana Garcia ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Influenza A ◽  
Gastrointestinal Symptoms ◽  
The United States ◽  
Adult Health ◽  
Care Providers ◽  
Panama City ◽  
Influenza A H1n1 ◽  
Level Institution

Introduction: In April 2009, a novel influenza A (H1N1) virus was identified in patients from Mexico and the United States.  From 8 May through 25 June 2009, in the Republic of Panama, 467 cases infected with the same virus were identified, 13 of which were hospitalized at the Santo Tomas Hospital in Panama City. Up to the date of this report, no deaths have been reported in Panama. This study presents the first thirteen cases of Influenza A (H1N1) 2009 that were hospitalized in Panama City. Methodology: The Santo Tomas Hospital (HST), a third-level institution of the Ministry of Health (MINSA) for adult health care (patients above the age of 14), was designated as the reference center for treating these cases. For this purpose, the norms and criteria established by the system were followed and every patient (case) presenting flu-like symptoms was included (fever equal or greater than 38ºC (100.4ºF), cough, sore throat, rhinorrhea, lethargy in children under the age of one, and respiratory distress). Results: Seventy-six patients were hospitalized as suspected cases for infection with the influenza A H1N1 2009 virus, of which 13 (17.1%) were confirmed as positive. The clinical picture was characterized by fever (100%), cough (92.3%), rhinorrhea (69.2%), malaise (53.8%), headache (53.8%), and only one case presented gastrointestinal symptoms (diarrhoea).  The male:female ratio was 1:2.2. Conclusion:  The knowledge and technology translation previously acquired through courses to the HST health care providers were the key in controlling the first influenza A (H1N1) 2009 cases.

Student-accessible healthcare records: A mixed-methods study of college student and provider

2016 ◽  
Vol 24 (3) ◽  
pp. 293-308
Author(s):  
Lori Keough ◽  
Julie Wright ◽  
Bonnie Watson ◽  
Tanya Nixon-Silberg ◽  
Suzanne Leveille ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Providers ◽  
Online Survey ◽  
Qualitative Interviews ◽  
Mixed Methods Study ◽  
Adult Health ◽  
Care Providers ◽  
Student Health Services ◽  
Provider Attitudes

This mixed methods study evaluated student and provider attitudes and expectations about offering students online access to their student health services visit notes (open notes). Six (N=6) health care providers from four public universities in northeastern Massachusetts participated. Qualitative interviews were completed by students (N=14) from one University in fall of 2013 and an online survey was completed at two universities in Spring of 2014. Attitudes and expectations were explored using qualitative data and descriptive statistics were used to analyze survey questions. Students’ interviews revealed that they desire control over their health and open notes would give them insight and involvement in their health care. Survey data supported these themes. In contrast, providers worried about how it could impact provider-patient relationships. Open notes has the potential to promote students’ understanding and responsibility for their healthcare, which could assist students in their transition from pediatric to adult health care.

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